Provider Demographics
NPI:1215426416
Name:GWIE, HYERYOUNG
Entity type:Individual
Prefix:MRS
First Name:HYERYOUNG
Middle Name:
Last Name:GWIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-1711
Mailing Address - Country:US
Mailing Address - Phone:201-281-5311
Mailing Address - Fax:
Practice Address - Street 1:217 WILSON DR
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-1711
Practice Address - Country:US
Practice Address - Phone:201-281-5311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17675200163W00000X
NY704561-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse